中重型子宫内膜异位症合并不孕用两种控制性超促排卵方案行体外受精-胚胎移植结局的比较

目的:比较中重型子宫内膜异位症合并不孕患者用两种控制性超促排卵方案行体外受精-胚胎移植(IVF-ET)的结局。方法:将2003年1月至2008年1月以超长方案行IVF-ET的中重型子宫内膜异位症不孕患者52例为研究组,按1:2配对选择同期用长方案患者104例为对照组。比较两组患者周期取消率、Gn起始剂量、Gn总量、获卵数、子宫内膜厚度、受精率、妊娠率、种植率、异位妊娠率及流产率。结果:两组周期取消率、获卵数、受精率、子宫内膜厚度、流产率及异位妊娠率均无显著差异(P>0.05);研究组Gn起始剂量及Gn总量均高于对照组,有显著差异(P<0.05);研究组妊娠率及种植率高于对照组,但无显著差异(P>0.05)。结论:中重型子宫内膜异位症合并不孕患者行IVF-ET时,用超长方案比用长方案会增加Gn起始剂量及总量,且有提高妊娠率及种植率的趋势。

Comparison of the outcome of IVF-ET conducted with two kinds of controled ovarian hyper-stimulation protocols on infertility patients with moderate or severe endometriosis

Objective:To compare the outcome of in vitro fertilization-embryo transfer(IVF-ET) conducted with prolonged protocol and long protocol on infertile patients with moderate or severe endometriosis.Methods:A case-control study was conducted on infertile patients with moderate or severe endometriosis regarding the IVF-ET outcomes in our center from January 2003 to January 2008.The study group included 52 patients applied with prolonged protocol.The control group included 104 patients matched-pairs taken from the patients applied with long protocol in the same time.The cancel rate,the dose of Gn,the number of oocytes,the thicken of endometrium,fertilization rate,pregnancy rate,implantation rate,abortion rate and ectopic pregnancy rate were compared between the two groups.Results:There was no obvious difference in the cancel rate,the oocytes retrieved,the thickness of endometrium,fertilization rate,pregnancy rate,implantation rate,abortion rate and ectopic pregnancy rate between the two groups(P>0.05).Both the initial and the total dose of Gn of the study group were higher than that of the control group.There was a significant diffrence(P<0.05).The pregnancy rate and implantation rate of the study group were higher than that of the control group,but there was no statistically significant difference(P>0.05).Conclusion:When IVF-ET is conducted on infertility patients with moderate or severe endometriosis,the prolonged protocol can increase the initial and total dose of Gn than the long protocol,and there is increasing tendency in pregnancy rate and implantation rate using the prolonged protocol than using the long protocol.